Sun Qing, Tang Liang, Zeng Qiurong, Gu Mingjun
Department of Clinical Nutrition, Fuling Center Hospital of Chongqing City, Chongqing, 408000, People's Republic of China.
Department of Endocrinology, Fuling Center Hospital of Chongqing City, Chongqing, 408000, People's Republic of China.
Diabetes Metab Syndr Obes. 2021 Apr 22;14:1773-1781. doi: 10.2147/DMSO.S265214. eCollection 2021.
In this study, we explored the correlation between diabetic retinopathy (DR) and metabolic syndrome (MetS) among diabetes mellitus (DM) patients.
Logistic regression analysis was utilized to test the effects of MetS and its indicators on the incidence of DR and vision-related functional burden. The spline smoothing functions of continuous indicators of MetS were used to establish the logistic generalized additive model (GAM). The effective degree of freedom (EDF) =1 was served as a sign of linear relationship. EDF>1 was a sign of a more complex association between MetS and DR.
The proportion of difficulties of looking for objects on the crowded shelves in the DR group was higher than that in the non-DR group (19.40 vs 12.10, <0.05). Elevated fasting glucose (Glu) and blood pressure levels were related to the vision-related functional burden. The risk of DR development increased by 6% [95% confidence interval (CI): 1.03-1.09, <0.001] and 1% (95% CI: 1.01-1.02, =0.004) per 1 unit increase in Glu and systolic blood pressure (SBP) of DM patients, respectively. In the univariate GAM, Glu had a linear effect on DR (EDF=1, <0.001) with a positive correlation after controlling SBP. And there was a nonlinear correlation between SBP and DR after controlling Glu (EDF=2.44, =0.024).
Both Glu and blood pressure were associated with the occurrence of DR and vision-related functional burden. Controlling the levels of Glu and blood pressure may reduce the risk of DR and vision loss among DM patients.
在本研究中，我们探讨了糖尿病（DM）患者中糖尿病视网膜病变（DR）与代谢综合征（MetS）之间的相关性。
采用逻辑回归分析来检验MetS及其指标对DR发病率和视力相关功能负担的影响。使用MetS连续指标的样条平滑函数建立逻辑广义相加模型（GAM）。有效自由度（EDF）=1作为线性关系的标志。EDF>1表明MetS与DR之间存在更复杂的关联。
DR组在拥挤货架上寻找物品困难的比例高于非DR组（19.40对12.10，<0.05）。空腹血糖（Glu）和血压升高与视力相关功能负担有关。DM患者的Glu和收缩压（SBP）每升高1个单位，DR发生风险分别增加6%[95%置信区间（CI）：1.03 - 1.09，<0.001]和1%（95%CI：1.01 - 1.02，=0.004）。在单变量GAM中，控制SBP后，Glu对DR有线性影响（EDF = 1，<0.001）且呈正相关。控制Glu后，SBP与DR之间存在非线性相关性（EDF = 2.44，=0.024）。
Glu和血压均与DR的发生及视力相关功能负担有关。控制Glu和血压水平可能降低DM患者发生DR和视力丧失的风险。
